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the appropriate role of colloids in managing fluid imbalance a critical review of recent meta-analytic findings适当的胶体的作用在管理液体失衡的关键评论最近的整合研究
/content/4/S2/S26
The appropriate role of colloids in managing fluid imbalance:
a critical review of recent meta-analytic findings
Andrew R Webb
UCL Hospitals, London, UK
Received: 3 August 2000 Crit Care 2000, 4 (suppl 2):S26–S32
Published: 13 October 2000 © Current Science Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X)
Abstract
Three meta-analyses have recently been reported on the relationship between choice of
resuscitation fluid and risk of mortality in critically ill patients. The relative risk of death
(1.16–1.19) in two of the meta-analyses was slightly higher in colloid than crystalloid
recipients; however, this observation was not statistically significant. In the third meta-
analysis, 6% (95% confidence interval [CI], 3–9%) pooled excess mortality was
documented in patients receiving albumin for hypovolaemia, burns or hypoalbuminaemia.
The mortality difference in hypovolaemia patients (4%; 95% CI, 0–8%) was not statistically
significant. A variety of serious limitations apply to the three meta-analyses, suggesting that
their findings be interpreted cautiously. More than one-half of the randomized controlled
trials (RCTs) included in the meta-analyses were reported prior to 1990 and hence do not
reflect current practice. Each meta-analysis included only a subset of relevant RCTs, and
therefore the scope of inferences to be drawn from the meta-analytic results is limited. The
meta-analyses combined RCTs that were notably h
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